Friday, December 29, 2017

Dialysis Patient And Will Travel. #dialysistraveler

Dialysis Patient And Will Travel

At Disney Sea Man-Made Lagoon

Me having dialysis at St. Lukes International Hospital

I am 65 years old and an End Stage Dialysis
Patient for six years now and I do not believe on someone who says that dialysis patients could not travel to other places like in their dreams. I have proven them wrong when my daughter Nadinne, who is a dialysis nurse in Australia carefully and painstakingly planned for a Singapore/Japan family travel and finally decided to push through with the said trip; of course I am included. Yes it is risky but it is worth taking the risk. At first I was not used to traveling but my body has adjusted to the situation and I started to enjoy: the fast boat to Cebu City and the airplane ride to Changi Airport in Singapore with my wife to rendezvous with my daughter Nadinne and my Son-In-Law Joshua who are coming from Australia. Changi Airport was decorated with beautiful flowers and orchids and we did not miss the photo opportunity  to pose and take pictures. Security and screening of incoming travelers is tight inside the airport as we pass the Custom's Area. As we went outside the airport I noticed that Singapore City is very clean and the climate is just right (not too hot and not too cold) the people are friendly and very organized. 

We took a van for hire and I gaze on the type of the van and it was a Mercedez Benz. People in Singapore have money I said to myself. There was no traffic congestion and our travel from the airport to the condominium unit of Joshua's brother was very smooth. After leaving our baggage and settling a bit, my wife, my daughter and her husband Joshua and Joshua's brother Jay and his family walked as I rode the wheelchair assisted by Joshua to the mall near their vicinity and we ate a dinner with assorted foods like crabs, fish, pork and noodles. I noticed in the basketball court and beside the mall  that we passed by that there were bicycles with the same design and color just left behind on their stand. I asked and I learned that those bicycles are owned by the government and can be used by means of a cell phone app. My impression is that it is a peaceful place and the government is very considerate to provide easy transport to their citizens. The government recognizes the importance of taking care of the environment by caring for trees and plants (the roads and hillside are lined with flowers and lush garden plants and trees). This is also true for Person With Disability (PWD) as malls, airports and train stations are provided with line of steel strips that guide the blinds and there are sufficient lifts or elevators to facilitate travel. We spent our night in the four room condominium unit of Jay and his family. The unit has enough space for a small family and has ample amenities. 

During our talk with Jay that night I have learned that in Singapore, you cannot own a land; you pay a certain amount for the condominium unit and if the government decide that another project will be put up at that place, they will pay you back what you paid to be used to pay the new unit that you will transfer in. The same is true if you decide to transfer to another place. That is why it is easy for the government to do Urban Planning. Most people are housed in condominium type (four to nine stories high) buildings and are clustered to form a community. Each community is provided with a mall and other necessary facilities to avoid unnecessary movement of people to prevent congestion in the streets. There is less visibility of uniformed policemen and crime is minimal.Taxes are high but wisely spent in various projects like infrastructure; not like in the Philippines where collected taxes were used to finance political projects aside from loss due to corruption. Please write your opinion in the comment section. It does not matter if you agree or disagree. Varying opinions is good. 

There are many Filipino workers in Singapore mostly professionals, Domestic Helpers and waiters in restaurants. Jay has hired one house help (distant relative of his mother). Hiring a house help in Singapore is not cheap; you have to pay a certain amount to the government on a monthly basis aside from the regular monthly salary. The employees and workers are well paid that is why they are contented and do their job well. I think there is job for everyone in Singapore. Just like in the Philippines there are rich people in Singapore and their income, quality of life differs quite significantly from other citizens. They say that if there is corruption in Singapore, it is very low.

Changi Airport
Changi Airport
On our second day in Singapore, we rode the train and I noticed immediately that the train system and network  is well planned (passenger friendly), well maintained and sufficient (there is a train passing by every five minutes) for mass transport that somehow prevented traffic build-up in the streets. The trains were new, clean and air-conditioned. People in Singapore love spicy foods, that is why you smell a spicy scent when you ride a train. It was like a maze inside the train station as we manage through escalators and stairs (sometimes we take a short cut) as lifts or elevators were not available (this is the hard and painful part as I am forced to stand from my wheel chair and walk). People are courteous and ready to help tourists to find their destination. The train took us near Sentosa Island, a leisure park accessible by cable cars. High above, you can see the bird's eye view of metro Singapore. You can ride the cable cars that loop around the island as long as you want. After stepping down from the cable car, we familiarized ourselves with the area and we later each of us rode the Luge (small cart with wheels) that can be easily maneuvered as it rolled down a slope and turns in snaky curves downhill. A cable lift took us back to the top of the hill where we came from.

View from the cable cars

Me and my wife at the boarding area of cable cars

Jay and his daughters and wife

Driving the Luge cart

Joshua, Belen, Me and Nadinne

At the Luge Entrance Area

Then, there was this four dimension movie house where you can see 3 D objects like logs, sawmill and crocodiles and you can feel the turns and bumpy ride in synchrony with the carousel you are riding in as it simulate the travel of logs in a river as it pass through the waterfalls (you can feel and see the drop) in a canyon until it reached the end of the line below. If someone in the viewers cannot proceed to finish the show due to fear or health problem, he can pull the lever and the show will temporarily stop and will proceed again after the said viewer that pulled the lever has left the room. There are enough food kiosks to satisfy hungry tourists. The sandwiches are very delicious, a little bit spicy and tasty. We visited the big MerLion statue where we climbed up to the top to see the panoramic view of Singapore. 

We continued to tour the area and posed for more pictures and proceeded to Universal Studio area located at the lower portion within the vicinity of Resorts World where there is a mall for celebrities selling signature clothes, bags and other items; of course aside from the delicious foods from many food stores. We posed for more pictures outside the mall with the original Merlion Fountain in the background at the other side of the Marina Bay area. We went back to the loading area of cable cars that took us back to mainland Singapore where we took a train going to China Town where we ate a sumptuous dish of Peking Duck, then after eating we looked for souvenir items for our friends back home.

On top of the Big Merlion Statue

At the Resorts World Vicinity
At the big Merlion Statue
Part of Sentosa Island (lower portion)

Part of Sentosa Island (lower portion)
Within the vicinity of Resorts World
Within the vicinity of Resorts World

On the third day we went to church. I noticed that there were many Filipinos and in fact the priest has announced that there was a schedule for a Filipino Mass. The church is huge and air conditioned. Then we ate breakfast in a Chinese restaurant and afterwards we rode the train to Gardens By The Bay area where we entered the  Cloud Forest. I was in awe at first sight of this man-made structure. Fogs and clouds were simulated inside a huge enclosure of glass that house a man- made mountain covered with many (I think all known tropical species were there) type of plants, flowers and orchids complete with water falls that create fine mist making the area more colder aside from huge air conditioners and misters. I admire very much 

Cloud Forest Waterfalls

Pose with huge palm trees

how Singapore give priority to large expensive projects about nature yet viewing it as an investment (boosting the tourism industry) with calculated financial returns. The Cloud Forest can be explored by the use of elevators and walk way around the man-made-mountain. We transferred to another gargantuan glass enclosure called the Flower Dome and toured the different types of plants as to countries like Asia and Africa. My wife Belen was all the while very happy and smiling as she looks at the flowers and orchids and Cacti (plural of Cactus) of various colors and sizes. Truly it is a gardener's and tourists' paradise. 

Belen with the Cloud Forest walkway at the background

There was a Santa's Cabin where many people lined up and waited for their turn to pose for family or group pictures. There were various Christmas lights twinkling in the area. As the dusk progresses, we watched the Super Trees light up with the huge merry Christmas lights and the beautiful Marina Bay Sands Hotel at the background. We left the Gardens By The Bay area and crossed a bridge to reach the original Merlion Fountain. We arrived at the Merlion Fountain with the Marina Bay Sands Hotel at the background in all its grandeur and glory as it perform the nightly laser lights and fountain show. It was awe inspiring as we pose for pictures beside the famous MerLion fountain that was popularized by a legend of a Mermaid with a lion head signifying the start of development of Singapore. 

Being a disciplined dialysis patient, I managed to survive the three day tour without dialysis. We went back to Cebu City and finally back to Tagbilaran City, Bohol where I had my regular dialysis.

Merlion Fountain

Super Tree at the Gardens By The Bay Area

My wife Belen at Merlion Fountain

Marina Bay Sands Hotel

Marina Bay View

After a few days rest, we traveled again from Tagbilaran City, Bohol to Manila on December 17, 2017 and the next day I had my dialysis at St. John Dialysis Center at Casman Bldg. at Quezon Avenue in Quezon City. I usually had my dialysis in Manila at Capitol Dialysis Center but now it is full to third shift and cannot accommodate transient patient like me.

On December 19, 2017, we started the second part of our tour which is Japan, particularly Tokyo, Kyoto and Osaka. When we landed at Narita Airport, I was surprised to see my name written in a placard held by a  young Japanese male attendant who was formally dressed all over in an attractive American suit. I did not know that my daughter has arranged for a wheel chair service because I have muscle and joint pain which is typical for a 6th year dialysis patient like me. The attendant was very courteous and helpful with smiling face. Narita Airport is huge, clean and very organized. The people are very courteous and very helpful of tourists. I had my first feel of Japan's weather when we went outside the airport to the train station and took a train that will take us to Tokyo. Boy it was really cold. Temperature inside the train was controlled by heaters maybe at room temperature and there were many passengers, so I had to take off my jackets and gloves again and put them back again when we reached Tokyo. I was not used to those heavy clothes, I felt I was so heavy and could not move properly. Using the GPS and walking, we searched for our Air BNB lodging house. Flag down rates of taxi in Tokyo was 4,000 Yen as they say. After some turns around the block we found our apartment type lodging house with two bedrooms that accommodated eight persons complete with heaters, WIFI, food snacks, appliances, soft cushioned beds, thick comforters and comfort room with toilet and bath. There was hot and cold water and the toilet have very modern electronic amenities with a touch of a button: Videt (focuses and wash a certain private part of your body), sprinklers (wash private parts with assistance of the hand). There are other buttons but I cannot understand because it is written in Japanese. My wife told me that it has a music button. Of course the music is in Japanese. At first I was hesitant to use the toilet bowl but I focused on the illustrated drawings and started experimenting. Then, at last, success! 

We first visited Senso-Ji Temple at Asakusa, Tokyo, Japan in the evening. I forgot to wear the right clothing for winter (gloves; scarf; thermal suit) and I felt so cold and I was afraid I would pass out especially when a slight wind is blowing. Thanks to the small food kiosks that line the streets that offered a cozy place and a hot meal. I can say I enjoyed but felt uncomfortable also because of the very cold weather. Then we went back to our lodging house and got a little nervous after getting lost in the streets for a while with my Son-In-Law Joshua who was pushing my wheelchair. Despite the cold weather outside I slept well that night.

Senso-Ji Temple
Senso-Ji Temple
House near Senso-Ji Temple

The second day is thrilling for us since we have to ride trains inside Japan's subway known for its maze like and not tourists friendly signs (all are written in Japanese); but thanks to the GPS and Google translations, we managed to find our way. At the train stations I noticed that all of the people are walking in wide strides and are in a hurry. All are lined up at the left side of the escalators because some prefer to walk in a hurry past other people who prefer to stand in the escalators. Japanese love their work very much and maybe their parents have taught them to value time, respect for other persons and money; it is in their culture. Employees at the train stations are helpful, respectful and polite. They are very professional in their uniforms and behavior. 

 I was reminded of a conversation between two student weight lifters (one student is a Japanese and the other one is Filipino) when I was still a student in College. Based on his observations, the Japanese weight lifter said to the Filipino weight lifter: "Philippines is a pond of frogs". It took a while for me to understand what the Japanese student said. Finally, it dawned on me that the Philippine sports training, as seen by the Japanese student, is sub-standard in terms of quality and quantity of time compared to Japanese training in the field of weight lifting. I was thinking that does this weakness is also true in other Filipino traits like discipline, honesty, self-respect, integrity and commitment and are reflected on how we work in the office whether it is in the private and government? Does this means that Filipinos are only imitating their leaders' examples but most of their leaders lack on these important traits that's why our country's development is not at par with Singapore and Japan? Am I right? Please put your comments below. 

It was morning in Tokyo and people were going to work. Every passing train was full of passengers and some, men and women, were standing with "zombie" like look on their faces (void of emotion); most were glued to their cell phones with matching earphones and some were comfortably snoring on their seats. Most men are in black suit and the women are in white dress.

Finally, we arrived at our destination for the day, the Disney Sea Theme Park which is the only one in Asia. The area is huge and organized to provide maximum entertainment to people at the right price (it cost 14,000.00 Yen per person) as well as bring in profits to Walt Disney Group. They have replicates of the Little Mermaid, Sinbad and the seven seas travel, Jules Verne's Twenty Thousand Leagues Under the Sea and other cartoons and movie themes. We arrived at the park at 10:30 A.M. and we saw around the man-made lagoon, groups of Japanese teens slumped (seated with folded knees) and clumped near each other at the concrete floor sharing body heat, busily using their cell phones and waiting for a show. Indeed at 11:00 A.M. the show of Disney characters started and there was a lively music and merry dancing around the lagoon. The in-active crowd suddenly jolted up to their feet and began waving and shouting with very happy faces. 

Then we strolled around the kingdom of little mermaid Ariel, pose for photos including the water fall at the foot of a man made volcano that formed part of Indiana Jones adventures. Inside the man-made volcano is a roller coaster ride where you can see and hear teens and kids enjoying the ride with loud shrieks. We did not ride the roller coaster but we chose the Twenty Thousand Leagues Under The Sea. Using the winding steel staircase we descended deep into a dark cavern and rode a miniature old model submarine. This ride mimic travel under the sea. As the submarine submerges, you can see in the circular glass window that the water is rising and you can see  curtain of bubbles. The lights and sound of the sea is great as well as the sea creatures like the giant octopus which seem to electrify the mini submarine as it passes through. There were many shows like the Big Band and Ariel the floating/flying and dancing mermaid. We became priority on every show because I rode my wheel chair and got good viewing. Then the night at about 7 P.M. was capped by a Mickey Mouse Mystical show of fireworks, fountains and orchestrated dances of Disney characters in boats parade in the lagoon. 

The night ended very merrily as contented tourists walked back to the Disney train that will take them to the city's train station. The park's attendants and employees were all very courteous and helpful. From the looks of it this is a classic signature of American  capitalists business venture capitalizing on the entertainment needs of children and adults; but satisfying indeed at the right price. We ate our meals in Japanese restaurants and it was there that I have proven that hunger is a great motivator and teacher as I finally learned to use the chop sticks for eating Ramen (fine noodles), Udon (bigger noodles) and Sashimis (set of raw fish, shrimp, squid, vegetables and sticky rice).

Near Ariel's Kingdom

Beside the man-made lagoon
Arabian Knights (Sinbad)
Ariel's (Little Mermaid) Kingdom
Man-made Volcano
Disney Sea (Zuma's Temple)

On the third day, December 21, 2017, we packed our baggage and we left our lodging house; we rode the train to the downtown business area and it was very cold outside since there was a prevailing wind. We were able to see the big and modern buildings and did not lose the opportunity to pose for a picture. We went to the bus station to leave our baggage and rode a train again to go to Shibuya crossing (popular for many people crossing the streets at one time) and pose for a family picture beside the statue of Hachiko the loyal dog who waited for his dead master to arrive at the station for many years. Then we ate Sashimis near my dialysis area. Afterwards, I had my first dialysis in Japan at the St. Luke's International Hospital at 3:00 P.M. I had a bit communication gap with the nurses but we were still able to understand each other and my dialysis smoothly went on until it was finished at 7 in the evening. From the hospital, we hurried to take a train ride to the bus station where a bus will take us to Kyoto. Like the participants in the Amazing Race, we were able to arrive at the station with only seconds remaining. The bus ride was 7 hours long but we were comfortable inside and the seats can be reclined. I looked outside as we travel and we were traveling through numerous houses, bus stations (the bus stopped for a few minutes for passengers to relieve themselves and also to take new passengers) and many lighted tunnels as the road to Kyoto is mountainous. When we arrived at Kyoto bus station, Kyoto temperature was 0 degree Centigrade at 4 A.M. and the biting cold was alleviated by a hot McDonald's meal. 

At Kyoto Station, we took a train to visit a Buddhist monk shrine called Fushimi Inari. This tourist site sits at the base of a mountain which is 233 meters above sea level. Trails leading up the mountain includes smaller shrines which span 4 kilometers and take approximately 2 hours to walk. I remained at the lowest portion as my companions climbed up to a few shrines. There were also praying and luck giving paper sheets that are sold by Japanese monks. After looking for food in the line of food stalls and eating Japanese fried noodles, we again took a train to Arashiyama bamboo forest or Grove (group of bamboos). This is where they shoot movies with Ninjas doing sword fights among the bamboos. The bamboos were clean of thorns, big and straight and they were side by side.

For the first time, we were able to ride the "Bullet" train at Shinkansen station going to Osaka. These modern trains are exclusive for those who can afford as the fares are soaring high; but the comfort and speed of travel is well provided. The buildings and other structures from the window seem to blur because of the high speed of the train. We arrived at Osaka in the late afternoon. Our room good for eight persons was of a studio type with heaters, bath, comfort room, kitchen and appliances. Our room in Tokyo was far better compared to Osaka. It is on the third floor and has no elevator and hand railings and it became dangerous and agonizing for me to climb and go down the stairs. No pain (including courage and determination) no gain.

Set of Sashimi items
Downtown Tokyo
Shibuya Crossing

Statue of Hachiko the loyal dog

Fushimi Inari Shrine
On top of Fushimi Inari

Me, Belen, Mariele, Nadinne, Mabelle and Adriane
at Bamboo Forest

Universal Studio (Harry Potter Castle)

On December 23, 2017, Nadinne with her two sisters Mariele, Mabelle and Joshua went to the Universal Studio while my wife Belen, my daughter Adriane, her husband Joel and I went to the Osaka Aquarium, the largest in Asia, we had some pictures with the whale sharks, other species of sharks, seals, penguins, king crabs and many species of fish; afterwards, we rode a train again and I had my second dialysis at the Shin-Osaka Iseikai Clinic which also went smoothly. The place was modern with complete facilities. I was surprised because I was able to tolerate a hi-flux dialyzer at 240 ml./min. blood flow for four hours straight. 

On our last day at Osaka, we were able to shop (some stores have tax free items) and eat at the Doton Bori, which is the "Divisoria" of Japan. Divisoria in the Phillippines is known for its cheap products and lots of people are shopping in the area. Doton Bori has lots of shopping and food stalls in long line which the tourists and locals can select from. Tourists are queuing in a long line to buy Takoyaki, a Japanese food with octopus as one of the ingredients. There were Koreans, Chinese, Filipinos and a few Caucasian tourists.

Joshua, Nadinne, Mariele and Mabelle

Osaka Aquarium (whale shark)

Joel, Adriane, me and Belen at Osaka Aquarium

Osaka Aquarium (KIng Crabs)

Doton Bori Bridge

Takoyaki (Japanese delicacy)

We again took a train that took us to the Kansai Airport. It is huge like Narita Airport and also very clean and organized. Our flight from Osaka to Manila was at 8:55 P.M. We arrived safely  in Manila at 12:20 A.M. Christmas day.

Our trip has provided enough bonding moments for our family and proved that disciplined dialysis patients can also travel if they are determined to endure physical pain to a tolerable degree. It also shows that countries with good and dedicated leaders can pull out from chaos and poverty to a well developed nation. Not like in the Philippines where full development has continued to lag behind other countries because of too much politicking and ineffective system of doing business and other transactions like the Red Tape that was supposed to provide check and balance became a dragnet for those opportunist gov't employees who are hungry for grease money from private contractors just to facilitate the movement of the required documents for bidding and award of projects and also for almost all gov't. transactions. They justify this by saying they have small salary and this pave for the existing "cancer" like system of corruption perpetrated by syndicates of gov't employees, dirty politicians and private contractors. As a result, the supposed original budget for the project is affected and the contractors have to skim on the project design resulting to a less quality infrastructure or supplies or machines and higher price of commodities. When will we learn from these mistakes and keep away from these evil deeds? Please write your feed-backs or comments. I will love to see them.

Sorry, because I cannot stop from comparing our beloved country the Philippines to other prosperous and developed countries like Singapore and Japan. It is our deepest desire that we Filipinos unite to make our country successful. This is just my way to create awareness no matter how small it is.

I do my travel not just for fun and sight-seeing. I always look for things that I wish our country could have also. 

I thank God for making my travel to other countries possible with the full support of my family. 

I chanced to read in the internet about a dialysis patient who dreamed of joining the Iron Man Triathlon. He did this with passion and determination; and one day he had the chance to fulfil his dream. He joined the Triathlon and was able to finish it.

My message to other dialysis patients is to be brave and try your best to travel to other places like in your dreams while you still can.


P.S.: Tips for dialysis traveling patients: The first thing to do before you travel is to go to your Nephrologist. Ask her/him if you are fit for travel. Have your blood test for regular monthly tests like Sodium, Potassium, Ionized Calcium, Inorganic Phosphorus, Albumin, Blood Uric Acid, Blood Urea Nitrogen, Serum Creatinine and CBC. Make sure the results are normal or near normal especially that of Hemoglobin value of your blood since Hemoglobin and Iron combined takes care of transporting oxygen to your cells. You do not want yourself panting or gasping for air as you travel from one place to another. You can also feel less cold if your Hemoglobin value is okay. The ideal Hemoglobin value is 11 or slightly higher. Before you travel, make sure your heart is okay and can take the rigorous part of your travel. You do not want to stress your heart to the point that you will have a heart attack. Take your medicines on time and regularly. Make sure your blood pressure is okay. Lastly, be sure to bring a wheelchair with you and a strong companion, preferably a male, to assists you as you ride your wheelchair. Of course, a strong determination, discipline and passion are needed to make your trip successful.